Cox-2及Salusin-a在急性冠脉综合征危险分层的预测价值

Predictive value of Cox-2 and Salusin-a in the risk stratification of acute coronary syndrome

摘要:

目的：探讨炎症因子 Cox-2及脂质因子Salusin-a对急性冠脉综合征（acute coronary sydrome，ACS）危险分层的预测价值及与主要危险因素的相关性。方法：入选110例行冠脉造影患者，根据患者的病史及冠脉造影结果分为3组：ACS组61例、稳定性心绞痛（stable angina pectoris，SAP）组19例、冠脉造影阴性者30例为正常对照（Control）组。其中 ACS组进一步划分为急性心肌梗死（acute myocardial infarction，AMI）组、不稳定心绞痛（unstable angina pectoris，UAP）组。Gensini评分系统对冠脉病变程度评分。ELISA盒测定血浆中的Cox-2、Salusin-a水平。结果：ACS组血浆Cox-2及超敏Ｃ反应蛋白（high sensitivity-C reactive protein，hs-CRP）水平明显高于 SAP组和 Control组 [（16.39±3.64） vs. （13.79±1.76）、（13.38±1.98） ng/ml，P=0.001、P=0.000；（5.61±6.77） vs. （1.50±1.48）、（1.35±1.49） mg/L，P=0.003、P=0.000]。AMI组血浆 Cox-2及超敏Ｃ反应蛋白（high sensitivity-C reactive protein，hs-CRP）水平亦高于 UAP组[（18.88±3.97） vs. （15.09±2.70） ng/ml，P=0.028；（9.05±7.92） vs. （3.67±5.18） mg/L，P=0.002]。ACS组及SAP组的血浆Salusin-a水平均低于Control组[（0.13±0.07）、（0.11±0.04） vs. （0.18±0.08） ng/ml，P=0.003、P=0.001]，而 ACS组与 SAP组 Salusin-a水平无统计学差异。结论：炎症因子 Cox-2与 hs-CRP能够对ACS危险分层具有预测价值；脂质因子 Salusin-a与冠心病发病密切相关，但并不能反映疾病的严重程度。

Abstract:

Objective：To explore the inflammatory factor of Cox-2 and lipid factor of Salusin-a’ s predictive value in the risk stratification of acute coronary syndrome（ACS） and the correlation among it’s main risk factors. Methods：One hundred and ten patients underwent coronary angiography（CAG） were divided into three groups：ACS group（n=61），stable angina pectoris（SAP） group（n=19） and control group（n=30） who had negative results in CAG according to their medical histories and CAG results. ACS group（n=61） was subdivided into acute myocardial infarction（AMI） group and unstable angina pectoris（UAP） group. ACS group was also divided into different groups based on the Gensini scoring system.Plasma levels of Cox-2 and Salusin-a were measured by ELISA. Results：Plasma levels of Cox-2 and high sensitivity-C reactive protein（hs-CRP） were significantly higher in ACS group than in SAP group and control group（（16.39±3.64） ng/ml vs. （13.79±1.76） ng/ml and （13.38±1.98） ng/ml，P=0.001，P=0.000；（（5.61±6.77） mg/L vs. （1.50±1.48） and （1.35±1.49） mg/L，P=0.003，P=0.000）. Plasma levels of Cox-2 and hs-CRP were significantly higher in AMI group than in UAP group （（18.88±3.97） ng/ml vs. （15.09±2.70） ng/ml，P=0.028；（9.05±7.92） mg/L vs. （3.67±5.18） mg/L，P=0.002）. Though Salusin-a level was lower in ACS group and SAP group than in control group（（0.13±0.07） ng/ml and （0.11±0.04） ng/ml vs. （0.18±0.08） ng/ml，P=0.003，P=0.001），it was not significantly different between ACS group and SAP group. Conclusions：Inflammatory factor of Cox-2 and hs-CRP have predictive value in the risk stratification of ACS. Lipid factor of Salisin-a is associated with coronary heart disease，but could not necessarily reflect the severity of the disease.